Case Rate/Agreed Rate in Medical Billing
A case rate or agreed rate is a flat fee paid to a healthcare provider for all services related to treating a particular case or condition.
Case Rate/Agreed Rate in Medical Billing Explained
In medical billing, case rates involve paying the provider a predetermined, all-inclusive fee for an entire episode of care, regardless of the number of services performed. This type of payment model is often used for surgeries, maternity care, or inpatient stays, where the total cost is bundled into one agreed-upon rate.
For example, a hospital might agree to a case rate of $5,000 for all services related to a knee replacement surgery, covering pre-op, surgery, and post-op care.
See common acronyms and abbreviations in Medical billing glossary.
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